Healthcare Provider Details

I. General information

NPI: 1043031107
Provider Name (Legal Business Name): JULIANNE RAINE VOIGHTS APSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/22/2024
Last Update Date: 10/22/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 W CAPITOL DR
MILWAUKEE WI
53212-1185
US

IV. Provider business mailing address

4416 S QUINCY AVE UNIT A
MILWAUKEE WI
53207-5221
US

V. Phone/Fax

Practice location:
  • Phone: 414-727-6320
  • Fax:
Mailing address:
  • Phone: 608-408-9132
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number134499
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: